title: How does dysautonomia influence the outcome of traumatic brain injured patients admitted in a neurorehabilitation unit?
abstract: BACKGROUND
  Patients surviving severe traumatic brain injury (TBI) may suffer from symptoms presumed to be related to an excessive sympathetic production known as paroxysmal sympathetic hyperactivity (PSH). While this condition is more common in the acute phase, prognosis is less clear in rehabilitation settings.
  
  
  OBJECTIVE
  The goal of this study is to describe the functional status of patients with PSH admitted in a rehabilitation hospital and to determine its prognostic influence during rehabilitation.
  
  
  METHODS
  A cohort study was undertaken of all the patients admitted in a neurorehabilitation hospital suffering from PSH. Functional outcomes were reported according to the Glasgow outcome scale-extended (GOSE), the Disability Rating Scale (DRS) and the Functional Independence Measure (FIM).
  
  
  RESULTS
  Thirteen out of 39 patients suffered symptoms compatible with PSH. Neuroimaging of PSH patients showed more diffuse lesions. The FIM at admission was lower in the PSH group who was transferred for rehabilitation at an earlier stage. At discharge no differences were seen using the FIM, DRS and GOS-E.
  
  
  CONCLUSIONS
  Functional status is similar and PSH does not appear to influence recovery during the rehabilitation, although PSH patients are more likely to undergo psychoactive medications and special care is needed to approach their caregivers that perceive PSH as a complication for rehabilitation.
authors.affiliation: Brain Injury Unit, Institut Guttmann-Universitat Autonoma de Barcelona , Badalona , Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Laxe
authors.forename: Rosa
authors.initials: R
authors.lastname: Terré
authors.forename: Daniel
authors.initials: D
authors.lastname: León
authors.forename: Montserrat
authors.initials: M
authors.lastname: Bernabeu
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D059907:Functional Neuroimaging; D023261:Glasgow Outcome Scale; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006948:Hyperkinesis / Q000209:etiology* / Q000503:physiopathology; D015994:Incidence; D008297:Male; D054969:Primary Dysautonomias / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D011379:Prognosis; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013564:Sympathetic Nervous System / Q000503:physiopathology*